Most boys are born with a penis that looks normal and works well. But some boys are born with a common condition called hypospadias. Hypospadias forms a penis that not only doesn’t work well but also doesn’t look normal. Pediatric urologists have come up with many surgical techniques to fix this problem. The following information should help you speak to your son’s urologist.
What is Hypospadias?
Hypospadias is a condition where the meatus isn’t at the tip of the penis. Instead, the hole may be any place along the underside of the penis. The meatus (hole) is most often found near the end of the penis (“distal” position). But it may also be found from the middle of the penile shaft to the base of the penis, or even within the scrotum (“proximal” positions). Hypospadias is a common birth defect found in up to 1 in every 200 boys.
In most cases, hypospadias is the only developmental problem in these infants and doesn’t imply there are other flaws in the urinary system or other organs.
Causes
The key steps in forming the penis take place between weeks 9 and 12 of pregnancy. During this time, male hormones tell the body to form the urethra and foreskin. Hypospadias may be caused by problems with hormones.
Diagnosis
Hypospadias is most often noticed at birth. Not only is the meatus in the wrong place, but the foreskin is often not completely formed on its underside. This results in a “dorsal hood” that leaves the tip of the penis exposed. It’s often the way the foreskin looks that calls attention to the problem. Still, some newborns have an abnormal foreskin with the meatus in the normal place. And in others a complete foreskin may hide an abnormal meatus. About 8 in 100 of boys with hypospadias also have a testicle that hasn’t fully dropped into the scrotum.
Treatment
Hypospadias is fixed with surgery. Surgeons have been correcting hypospadias since the late 1800s. More than 200 types of operations have been described. But since the modern era of hypospadias reconstruction began in the 1980s, only a handful of techniques have been used by pediatric urologists.
The goal of any type of hypospadias surgery is to make a normal, straight penis with a urinary channel that ends at or near the tip. The operation mostly involves 4 steps:
- straightening the shaft
- making the urinary channel
- positioning the meatus in the head of the penis
- circumcising or reconstructing the foreskin
Hypospadias repair is often done in a 90-minute (for distal) to 3-hour (for proximal) same-day surgery. In some cases the repair is done in stages. These are often proximal cases with severe chordee. The pediatric urologist often wants to straighten the penis before making the urinary channel.
Surgeons prefer to do hypospadias surgery in full-term and otherwise healthy boys between the ages of 6 and 12 months. But hypospadias can be fixed in children of any age and even in adults. If the penis is small, your health care provider may suggest testosterone (male hormone) treatment before surgery.
A successful repair should last a lifetime. It will also be able to adjust as the penis grows at puberty.
Reference:
https://www.urologyhealth.org/urologic-conditions/hypospadias